kajcomp
03-21-2008, 11:44 PM
My Dad (80 years old) just got out of the hospital due to difficulty breathing due to fluid in lungs (5 week stay - 2 in hospital, 3 in Transitional Care Unit). He has advanced heart failure, COPD and osteoarthritis, bad kidney function because of all the diruetics he has taken for approximately 5 years, and also chronic gout. His ejection fraction on his heart is 15% which means that his heart's pumping ability is very bad and he is almost immobile. Prior to his hospital stay, his only prescribed drugs were Diovan for hypertension, allopurinol for gout, demedex diuretic, cardura diuretic for urinary/prostate, prescription potassium and darvocet for pain, and a daily aspirin. Now my Dad's list of meds include: Coreg (beta blocker), Plavix, Lasix (diuertic for fluid in legs and lungs), Digoxin (to improve pumping ability of the heart, magnesium oxide, daily aspirin, darvocet for pain, Diovan for hypertension, Allopurinol for gout, Flomax for prostate/urinary, Miralax for constipation that is caused from all the drugs, Megace for appetite stimulant because some of these drugs will reduce appetite, Breathing Treatments - Spiriva/Brovana, Duoneb.
My questions are concerning his total demeanor that changed drastically from the beginning of his hospital stay until the present day. He has been home for about 2-1/2 weeks now. From the onset of being given these new meds in the hospital, he has been unable to sleep through the night, only napping very lightly during the day. He is totally miserable, freezing cold all the time (electric blanket sometimes won't even get it), pulling covers up and then off, having to have the pillows he sits on "just a certain way,so as not to put pressure on his tender backside", readjusting constantly the pillows, blankets, up and down constantly to the bathroom because of the diuretics and not being successful half the time. He is very unconcerned about watching TV programs he enjoyed before entering the hospital or even reading the paper - really he doesn't want to do anything but just sit. He does not see the point in doing the least little physical therapy to keep him slightly mobile - doesn't see the point because he doesn't see the necessity in it. Will not take a chair bath until absolutely necessary (every 2 weeks is okay with him) - this is because he claims the water freezes him although the bathroom is so hot like a sauna and the washcloth is blazing hot - it all still "feeezes" him and he says that he is half dead now and why should he do something like that if it is not totally necessary. Also, he goes through periods of time where what he says makes no sense at all - pure gibberish. But at times, it is like he is aware of what he just said that made no sense. He will also use curse words when he is ridden with anxiety about his coldness and also when he is uncomfortable on his backside - then he has had outbursts with us, his daughters only, no one else so far, where he says things like, "I can't live like this, I'd rather be dead" and "i'm no good to anyone like this", and I wish I had just died" and I'd rather be dead and "I'm just going to kill myself". These comments are very much NOT like anything my Dad would say. His mind was extremely good up until his hospital stay. He also will say if we will let him go home (to his house alone and he is a widower and would be alone there) then he could get warmed enough there and would be more comfortable and one time he said that he would go there and just kill himself. Well, he is living with me, his daughter, and I have made every effort for his comfort and warmth - if he could only know what efforts my family have made to have him with me as he cannot go home and be alone, not in his condition, doctor's orders is that someone has to assist him on his walker at all times. The minute it hits midnight, if he has napped late, every night he does this - he awakens and starts going back and forth to the bathroom, turning the electric blanket on, pulling it on him for about 5 minutes and then throwing it off and turning it off, adjusting the pillows constantly, wandering around throughout the night with little and no sleep throughout the night and during the day, he naps very little - maybe 30 minutes maximum. Quite honestly, he has not had a full night's restful sleep in about 8 weeks now. I frankly do not understand how he is even making it as well as he is with no proper rest for that long. I have to be attentive to him most every minute of the day, as he is constantly wanting me to pull his blankets around him to his back and keep his pillows adjusted accurately, etc. When I take him for a Doctor's appointment, he presents himself outside the home as if he is just okay, and the minute I get him to my home and he gets in the house, he starts to get irritated with something - anything and displays, verbally, his total unhappiness with his situation - sometimes he gets so agitated that I feel that he could become violent and fear what he might do. One day, during an agitated event, he said that he thought he was loosing his mind and that we could just put him in the state psyciatric hospital. So he is aware sometimes that something is terribly wrong with him These actions are so very unlike the way I have always remembered him and certainly was not him immediately before entering the hospital. He was always a very calm, collected, sedate, gentle, kind and caring man with not ever very many harsh words that I can remember. He is now very irrational for most of the time and makes no sense when he says thing (almost like Alzheimers), then to turn around and then make perfect sense - just like Dr. Jekyl and Mr. Hyde. While in the hospital, when we saw he was not sleeping, as we stayed with him 24/7, they gave him Lunesta to sleep and he didn't sleep a wink at night and became extremely irritated and agitated and mean at night saying things like "I am going to jump out that window" - then it was changed to Resterel another sleeping pill, same thing there, then it was changed to Ambien with the same results. Absolutely no sleep until about 6:00 a.m. and then he would sack out with a swollen bottom lip head hanging for several hours. Then they thought he was depressed and gave him an antidepresnt Celexa and it didn't help to relax him at all - same problems. I will have to say that since we are out of the hospital that the magnitude is not as great as it was in the hospital, however the same patterns and events still exist. I was told that these things happen to people that stay in the hospital that long. I can believe that somewhat, however, after looking up all the drugs that he is now taking, I am finding that almost each one of them can cause anxiety, insomnia and mental changes. Well, all I can say is that he is one very miserable man and that if taking him off all of the medicine will bring back my Dad to the person he was born to be, then I believe that I could opt to have quality of life over quantity of life. I truely hope that I can get a good response as to the cause of these problems and some clues as to what to do about them as I don't know if I will be able to deal with him like this. How could anyone change so drastically just by being put into the hospital. The only thing that I believe would be the cause of his behavior changes are these drugs - am I right? I think I am.
Thanks in advance for any time anyone could afford me.
My questions are concerning his total demeanor that changed drastically from the beginning of his hospital stay until the present day. He has been home for about 2-1/2 weeks now. From the onset of being given these new meds in the hospital, he has been unable to sleep through the night, only napping very lightly during the day. He is totally miserable, freezing cold all the time (electric blanket sometimes won't even get it), pulling covers up and then off, having to have the pillows he sits on "just a certain way,so as not to put pressure on his tender backside", readjusting constantly the pillows, blankets, up and down constantly to the bathroom because of the diuretics and not being successful half the time. He is very unconcerned about watching TV programs he enjoyed before entering the hospital or even reading the paper - really he doesn't want to do anything but just sit. He does not see the point in doing the least little physical therapy to keep him slightly mobile - doesn't see the point because he doesn't see the necessity in it. Will not take a chair bath until absolutely necessary (every 2 weeks is okay with him) - this is because he claims the water freezes him although the bathroom is so hot like a sauna and the washcloth is blazing hot - it all still "feeezes" him and he says that he is half dead now and why should he do something like that if it is not totally necessary. Also, he goes through periods of time where what he says makes no sense at all - pure gibberish. But at times, it is like he is aware of what he just said that made no sense. He will also use curse words when he is ridden with anxiety about his coldness and also when he is uncomfortable on his backside - then he has had outbursts with us, his daughters only, no one else so far, where he says things like, "I can't live like this, I'd rather be dead" and "i'm no good to anyone like this", and I wish I had just died" and I'd rather be dead and "I'm just going to kill myself". These comments are very much NOT like anything my Dad would say. His mind was extremely good up until his hospital stay. He also will say if we will let him go home (to his house alone and he is a widower and would be alone there) then he could get warmed enough there and would be more comfortable and one time he said that he would go there and just kill himself. Well, he is living with me, his daughter, and I have made every effort for his comfort and warmth - if he could only know what efforts my family have made to have him with me as he cannot go home and be alone, not in his condition, doctor's orders is that someone has to assist him on his walker at all times. The minute it hits midnight, if he has napped late, every night he does this - he awakens and starts going back and forth to the bathroom, turning the electric blanket on, pulling it on him for about 5 minutes and then throwing it off and turning it off, adjusting the pillows constantly, wandering around throughout the night with little and no sleep throughout the night and during the day, he naps very little - maybe 30 minutes maximum. Quite honestly, he has not had a full night's restful sleep in about 8 weeks now. I frankly do not understand how he is even making it as well as he is with no proper rest for that long. I have to be attentive to him most every minute of the day, as he is constantly wanting me to pull his blankets around him to his back and keep his pillows adjusted accurately, etc. When I take him for a Doctor's appointment, he presents himself outside the home as if he is just okay, and the minute I get him to my home and he gets in the house, he starts to get irritated with something - anything and displays, verbally, his total unhappiness with his situation - sometimes he gets so agitated that I feel that he could become violent and fear what he might do. One day, during an agitated event, he said that he thought he was loosing his mind and that we could just put him in the state psyciatric hospital. So he is aware sometimes that something is terribly wrong with him These actions are so very unlike the way I have always remembered him and certainly was not him immediately before entering the hospital. He was always a very calm, collected, sedate, gentle, kind and caring man with not ever very many harsh words that I can remember. He is now very irrational for most of the time and makes no sense when he says thing (almost like Alzheimers), then to turn around and then make perfect sense - just like Dr. Jekyl and Mr. Hyde. While in the hospital, when we saw he was not sleeping, as we stayed with him 24/7, they gave him Lunesta to sleep and he didn't sleep a wink at night and became extremely irritated and agitated and mean at night saying things like "I am going to jump out that window" - then it was changed to Resterel another sleeping pill, same thing there, then it was changed to Ambien with the same results. Absolutely no sleep until about 6:00 a.m. and then he would sack out with a swollen bottom lip head hanging for several hours. Then they thought he was depressed and gave him an antidepresnt Celexa and it didn't help to relax him at all - same problems. I will have to say that since we are out of the hospital that the magnitude is not as great as it was in the hospital, however the same patterns and events still exist. I was told that these things happen to people that stay in the hospital that long. I can believe that somewhat, however, after looking up all the drugs that he is now taking, I am finding that almost each one of them can cause anxiety, insomnia and mental changes. Well, all I can say is that he is one very miserable man and that if taking him off all of the medicine will bring back my Dad to the person he was born to be, then I believe that I could opt to have quality of life over quantity of life. I truely hope that I can get a good response as to the cause of these problems and some clues as to what to do about them as I don't know if I will be able to deal with him like this. How could anyone change so drastically just by being put into the hospital. The only thing that I believe would be the cause of his behavior changes are these drugs - am I right? I think I am.
Thanks in advance for any time anyone could afford me.